A study investigated whether lowering the reading level of a health education pamphlet would increase comprehension by adult English-as-a-Second-Language (ESL) readers. The reading level of a general pharmacy education handout was lowered by changing vocabulary, sentence structure, and organization, by highlighting the main idea of each point, and by writing an introduction designed to catch attention and focus reading. Low-intermediate and advanced ESL college students read either the unaltered (n=25) or altered (n=24) versions of the pamphlet, which were estimated to be at the grade 12 and grade 7 level, respectively. Subjects then answered a free written test and a short-answer test. There was no statistically significant difference in the reading comprehension scores of the two groups on either test. The results suggest that health educators and ESL professionals should be wary of using readability formulas to estimate the suitability of materials for ESL readers, and of assuming that lowering the reading level of materials means increasing comprehension even when some changes beyond the lexical and syntactical are made. Excerpts from the tests are appended. (Contains 12 references.) (Author/LB) (Adjunct ERIC Clearinghouse on Literacy Education)